Yan Ren, Earl Chase, Tania d’Almeida, Julien Allègre, Paule Latino-Martel, Valérie Deschamps, Pierre Arwidson, Fabrice Etilé*, Serge Hercberg, Mathilde Touvier, Chantal Julia
This article was originally published in the October 2021 edition of the 5 papers…in 5 minutes.
Although alcohol consumption has decreased by 50% in France since the World War II, it remains central in French food culture and practices. France currently ranks sixth among OECD countries for total alcohol consumption per capita. Alcohol is a major cause of morbidity and mortality, through diseases, accidents and violence leading to premature death. Alcohol consumption caused 41,000 deaths in France in 2015, or 7% of total mortality. Alcohol consumption also contributed to a large proportion of morbidity, in particular cancer, with 7.9% of new cancer cases attributable to alcohol in 2015 (1). In 2018, a conference of experts convened under the aegis of Santé Publique France and the National Cancer Institute updated the alcohol consumption guidelines. The recommendation sets a weekly maximum of 10 standard glasses of alcohol, a daily maximum of 2 standard glasses, and several days of abstinence per week. What would be the public health benefits of reducing alcohol consumption in France?
In an epidemiological study conducted with researchers from the Equipe de Recherche en Epidémiologie Nutritionnelle, Fabrice Etile and his co-authors built a model evaluating the decrease in the incidence of cancers that would be observed if all French people respected the consumption guidelines. They simulate the impact of a change in alcohol consumption on the number of new cancer cases in France over a 36-year period (2014-2050), taking into account the specific effects of consumption on each cancer localisation. The authors calibrate the model using epidemiological data on the risks of alcohol and the demography of the French population. They show that if the entire population adhered to the recommendations, approximately 15,952 cases of cancer could be prevented per year (2025-2050), with a strong gender effect linked to overconsumption by men (i.e. 12,954 cases prevented in men compared with 2,998 in women).
This epidemiological simulation study shows that effective policies to regulate alcohol consumption could have significant impacts on public health. In addition to cancers, alcohol abuse is a risk factor for many physical and mental illnesses, and a cause of accidents and violence to self and others. The dissemination of general information is currently the main tool used by public health authorities to raise awareness of the dangers of alcohol consumption, and to encourage the adoption of appropriate drinking behaviour. However, public health experts and international organizations consider public regulation of alcohol prices to be an essential component of any prevention policy. Systematic reviews of the empirical literature show that price increases have a significantly negative impact on alcohol consumption and associated health harms, including in high consumption populations. From this perspective, French alcohol taxation is marked by a disconnection from health issues. Thus, if we consider that the health risks of consumption depend essentially on the pure alcohol content of drinks, the tax burden on wines is extremely low, even though they represent more than 50% of the volumes of pure alcohol sold. When will alcohol pricing policies be reformed?
(1) Bonaldi C, Hill C. La mortalité attribuable à l’alcool en France en 2015. Bulletin Epidemiologique Hebdomadaire 2019; 97-108.
Original title of the article: Modelling the number of avoidable new cancer cases in France attributable to alcohol consumption by following official recommendations: a simulation study
Published in: Addiction. 2021 Sep;116(9):2316-2325. doi: 10.1111/add.15426. Epub 2021 Feb 18. PMID: 33565659.
Available at: https://pubmed.ncbi.nlm.nih.gov/33565659/
Credits (picture): Pormezz – Shutterstock
* PSE Professor